This invention relates to a suture-needle combination. More specifically, it relates to a novel suture configuation which facilitates tying a suture knot endoscopically.
As medical and hospital costs continue to increase, surgeons are constantly striving to develop advanced surgical techniques. Advances in the surgical field are often related to the development of operative techniques which involve less invasive surgical procedures and reduce overall patient trauma. In this manner, the length of hospital stays can be significantly reduced, and therefore the hospital and medical costs can be reduced as well.
One of the truly great advances in recent years to reduce the invasiveness of surgical procedures is endoscopic surgery. Endoscopic surgery involves the use of an endoscope, which is an instrument permitting the visual inspection and magnification of any cavity of the body. The endoscope is inserted through a cannula after puncture through the wall of the body cavity with a trocar, which is a sharp-pointed instrument. The surgeon can then perform diagnostic and therapeutic procedures at the surgical site with the aid of specialized instrumentation designed to fit through additional cannulas providing openings into the desired body cavity as may be required.
In the vast majority of surgical procedures, including those involved in endoscopic surgery, it is necessary to close wounds with sutures. The integrity of the suture closing depends on not only the type of suture used, but also the knot configuration used for tying suture strands.
Surgeons and physicians commonly rely on two types of knots when working with sutures: a) a stay suture knot, and b) an interrupted stitch knot. The stay suture knot, often referred to as an "anchor" knot, is used by the surgeon to anchor a suture in tissue for a continuous line of stitches. The anchor enables the surgeon to stitch a continuous line of stitches and yet maintain the integrity of the closure with the anchor knot. Since the continuous line of stitches provides a significant amount of security for closure, the degree of strength required for the stay suture knot is not as great as that for an interrupted stitch knot.
An interrupted stitch knot is truly an independent knot. It is frequently used during tissue repair to improve the security of closure of a wound. The interrupted stitch knot may be used at the conclusion of closure of an incision after a continuous line of stitches has been laid by the surgeon. Once the continuous line of stitches is laid, the surgeon will tie an interrupted stitch knot to provide the greatest amount of security which he is capable of providing. The interrupted stitch knot is a knot used for tying two ends of a single suture strand together in one stitch. It does not rely on a cumulative row of stitches for additional strength, so it is critical that an interrupted stitch knot have a high degree of security and strength.
Unfortunately, the required degree of security of suture knots is difficult to achieve during endoscopic operations because of the difficulty of maneuvering a suture strand within such closed quarters. This is especially true in those situations where it is necessary or desirable for the surgeon to tie an interrupted stitch knot, which requires the greatest amount of security and strength. The tying of such knots frequently is time consuming and laborious even under optimum conditions, and is especially so during endoscopic conditions. In view of these difficulties, it would be most desirable if a new suture configuration could be fabricated which would allow the surgeon or physician to easily tie a suture knot with the requisite amount of strength and security in a short time period.